


PoTS

by BlueNeutrino



Series: When Two Hearts Beat As One [12]
Category: Supernatural
Genre: Doctor Castiel, Gen, Heartbeats, Sick Sam, Worried Dean, pots - Freeform
Language: English
Status: Completed
Published: 2017-03-26
Updated: 2017-03-26
Packaged: 2018-10-11 02:33:18
Rating: General Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 1,065
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/10453014
Author URL: https://archiveofourown.org/users/BlueNeutrino/pseuds/BlueNeutrino
Summary: Sam's been having the episodes for a while - the sudden heart palpitations, the lightheadedness, the shortness of breath. When he can't hide it from Dean any longer, it's time to turn to Cas for help.





	

**Author's Note:**

  * For [JulyFalconeri](https://archiveofourown.org/users/JulyFalconeri/gifts).



> For goddessofwincest on Tumblr. I hope this helps <3

It’s been going on for weeks before Sam can’t hide it anymore. Truth is, Dean’s already noticed: the shortness of breath, the color suddenly draining from Sam’s face when he stands, the clutching at his chest when he thinks Dean’s not looking. Dean’s not said anything either, never pushing more than to just check Sam’s okay, and usually being met with gruff dismissal and assurances his brother’s fine.

It’s only when Sam almost passes out from nothing more than standing that they can’t ignore it anymore.

“Sammy,” Dean says, darting to his brother’s side from where he’s just tried to rise from a chair in the bunker’s library. “Hey, I got you.” He helps Sam ease himself back down, dizzy and blinking to clear his head. “What’s wrong?”

“Nothing, Dean. I’m fine.”

“No, you’re not. You almost passed out, man, and don’t lie to me. This isn’t the first time.”

Grimacing, Sam looks down. “My heart’s just randomly started pounding. It’s been doing this off and on for a while.”

That’s cause for concern. Worried, Dean presses his fingertips to Sam’s throat, feeling the rapid thrumming in his carotid artery. Yeah, that’s got to be at least 140 bpm. Jesus. “Alright, I’m calling Cas.”

“Dean!” Sam protests. “That’s not necessary. It’ll calm down soon.”

“You’re thirty-four, dude, getting up from a table. It shouldn’t be doing in the first place. Last thing we need is for you to develop a heart condition.”

There’s a beat, then Sam concedes with a nod. He’s still wearing a look of discomfort. “Alright. If you think it’ll help.”

“Hell, maybe you’ve been cursed,” Dean suggests, looking for an explanation that might convince them this is still in the realm of everyday things they deal with, though his brother doesn’t seem convinced. “I should check your room for hex bags.”

Sam doesn’t feel up to it. “Knock yourself out, but I don’t think that’s what this is.” He wishes it was, but he has a gut feeling that there’s else wrong. Something that’s making him almost constantly tired and anxious, and right now is making him feel pretty sick. “I’m gonna go lie down.” He gets up again, steadily, and Dean holds an arm out to support him. Sam shakes his head, but it doesn’t stop his brother hovering like a hawk, just as he had when Sammy had taken his first few steps as a toddler, still unsteady on his feet. 

Dean can see the pulse fluttering at the base of Sam’s throat, disconcertingly fast. He finds himself remembering what it was like when he’d been diagnosed with a heart condition, leaving him perpetually cold and queasy while painful palpitations would hit without warning. He prays that somehow, something similar hasn’t happened to Sam.

They eventually make it to Sam’s room, where Sam collapses onto the bed and Dean starts rearranging the furniture as he chases the slim chance that this is all just a curse. Maybe it’s some game of Rowena’s, though even with his distaste for the witch, Dean can’t riddle a way that makes sense in his head. Predictably, he hasn’t found a hex bag by the time Cas gets there.

The angel takes Sam’s pulse, frowning as he finds it still elevated, though not quite at the gallop of earlier. “Dean, go to the infirmary and fetch me the stethoscope,” he instructs, and then feels for Sam’s temperature with a tender touch to his forehead. “How are you feeling?” he asks gently once Dean’s left the room.

“Kinda nauseous,” Sam replies, still feeling his heartbeat like the wings of a hummingbird. This is the worst episode he’s had in a while, and if he’s honest with himself, he’s scared. “I hoped this would start getting better on its own, but it’s not.”

“Hmm.” Cas’ brow creases, thoughtful. If he’s worried, he doesn’t let it show. When Dean returns with the stethoscope, the angel puts it on and warms the end before lifting Sam’s shirt, carefully pressing it to Sam’s chest. Cas’ expression turns to one of concentration, focusing on the sound of Sam’s heart as he performs his exam. He listens in several spots, Dean watching on anxiously, before placing a steadying hand on Sam’s shoulder and asking him to sit up. The chestpiece remains in place as the younger Winchester does as he’s told, though Sam can’t help but grimace as the action again causes his heart to jackhammer, kicking fiercely against his sternum.

Cas nods, removing the stethoscope from his ears and helping Sam lie back down. “Sam, I think it’s possible you have PoTS - Postural Orthostatic Tachycardia Syndrome.”

Sam’s eyes widen, but it seems to get more of a reaction from Dean. “Shit. Are you saying he actually _does_ have a heart condition?”

“It means sudden changes in position, such as moving from sitting to standing, can trigger an unusually elevated heart rate, but it should be manageable with things such as controlled fluid intake or medication.”

That doesn’t seem to be much reassurance. Sam pulls a face. “I’m a hunter, Cas. I spend half my life getting thrown around by monsters; I don’t need this.”

“Sam.” Cas touches his forehead again, a gesture of comfort. “Let me help.”

There’s a beat, Sam frowns in confusion, and then he feels the warm glow of grace radiating from Cas’ hand. It trickles down the back of his skull to his neck and then spreads lower throughout his chest, calming the racing of his heart. Breathing becomes easier, and finally Sam sighs as the dizziness clears from his head.

“I know you, Sam,” Castiel’s voice says from close by. “You’ve dealt with worse than this. You’ll be okay.”

“Yeah,” Dean’s adds. “And you have us. If you get sick, man, you gotta tell me sooner. We can help.”

The look on Dean’s face tells Sam he shouldn’t have tried to hide it this long. He knows it, but dammit, they’ve both always been so stubborn about things like this. Why can’t they sometimes just accept help?

Still, it’s comforting now that Cas and Dean know, now that he has some kind of explanation. His heart may have decided to start pounding out a drum solo every time he moves too fast, but it’s not the first long-term health problem he’s dealt with.

He can manage it. He has Dean and Cas.

He’ll be okay.


End file.
